Christine Marie Mederos, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP012725 Issued in GA

Practice address

3295 River Exchange Dr Ste 170
Peachtree Corners, GA 30092-4220

Phone

(770) 862-6447

Fax

(678) 691-2882

NPI assigned

Aug 30, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Scoop Speech, LLC

  • Speech-Language Pathologist
  • Norcross, GA
  • NPI 1558077677
  NPD
• Therapy Goals LLC

  • Speech-Language Pathologist
  • Tucker, GA
  • NPI 1558906024
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1699550301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3295 RIVER EXCHANGE DR STE 170",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300924220",
            "fax_number": "678-691-2882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3295 RIVER EXCHANGE DR STE 170",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300924220",
            "telephone_number": "770-862-6447",
            "fax_number": "678-691-2882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDEROS",
        "first_name": "CHRISTINE",
        "middle_name": "MARIE",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-30",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP012725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annie McFadden, THERAPIST
• Tracy Dishon McGarvey, RN,ADMINISTRATOR
• Akemi-Joi McGoogan, LCSW
• Dominique Jacqueline McIntosh, FNP
• Megan Tayler McPherson
• Emmanuela Medrea, RPH
• Medstop , LLC
• Joshua Meeks, PHARMD
• Sara Gheesling Melito, LPC
• Alan Brad Miller, M.D.

• Speech-Language Pathologist in Peachtree Corners, GA
• Providers in Peachtree Corners, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.